Dr. Le Thu, 71, of Boston, was sentenced on Oct. 6 to 36 months in prison, three years, for signing Medicare orders for patients she had never treated. She was also ordered to pay over $27 million in restitution. Medicare paid more than $27 million on claims that came from her orders.

Orders signed without a patient visit

The U.S. Attorney’s Office for the District of New Jersey said in a sentencing announcement that Thu signed thousands of orders for genetic tests and medical equipment for Medicare patients. Before signing, she had not interacted with those patients or provided them any medical care. Some of the orders were signed by staff who had no medical training.

The claims built on those orders added up to more than $40 million, according to the announcement. Medicare paid more than $27 million of that. The restitution order is for over $27 million, in line with what Medicare paid rather than what was billed.

The announcement also describes an earlier scheme, from 2014 to 2017, in which Thu took about $35 per prescription in telemedicine kickbacks. The $35 figure is the per-prescription payment, and it came from a telemedicine arrangement that ran before the orders at the center of the sentence.

For anyone on Medicare, the lesson in the case is about who sits at the other end of an order. A doctor’s signature is what lets a lab or an equipment supplier bill Medicare for a test or a brace. When the signature belongs to a doctor who never saw the patient, the patient may not know an order exists until a statement arrives showing a charge for something never received. Medicare patients who read their statements against their own memory of what they had done are the ones who can catch that.

The next step is collecting the over $27 million in restitution, and no payment schedule has been published.

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Why genetic tests and equipment

Medicare’s own booklet on protecting against fraud lists the kinds of billing that suspicious providers use. Among them are charges for “genetic tests when you don’t need one or don’t meet Medicare coverage rules,” and charges for a back brace or other orthotics, a power wheelchair or a scooter. It also warns about providers that bill for “services, supplies, or equipment you didn’t get.” Those are the two categories in the Thu case: genetic testing and medical equipment.

The booklet is published by Medicare in its guide to protecting yourself. It describes the problem from the patient’s side, and the court case describes it from the provider’s side. Taken together they show the same gap: the person whose name is on the claim is often the last to hear about it.

What the sentence covers

The 36-month term and the restitution order came out of the same sentencing, on Oct. 6. The U.S. Attorney’s Office published its announcement two days later. Together they put a number on the loss to Medicare, over $27 million, and a number on the time the doctor will spend in prison, three years.

The loss the court counted is the program’s. Medicare paid the claims, so Medicare is the party the restitution is owed to. The announcement does not describe patients paying anything themselves, and it does not say any of them knew the orders existed.

How Medicare tells patients what was billed

The Medicare Summary Notice is the statement most people on Original Medicare get. Medicare’s booklet says it arrives by mail “every 3 months for Part A and Part B-covered services,” and that people who sign up for electronic notices get an email monthly when a notice is available in their Medicare account. It shows the services or supplies billed, what the provider charged and how much Medicare paid.

That is where an order like the ones in the Thu case would show up. A lab test or a piece of equipment the patient does not remember, billed by a company the patient has never heard of, is the sign to look at more closely. The booklet’s advice for a charge that looks wrong is to call the provider’s office, since many errors are honest billing mistakes that get corrected.

Going through a Medicare Summary Notice

The routine takes a few minutes. Medicare says to look at each notice for accuracy: the services or supplies listed, the amount charged and the amount Medicare paid. A calendar or a list of appointments makes it easier. The Medicare fraud page suggests setting up a secure Medicare.gov account so claims can be seen once they are processed, instead of waiting for the mailed notice.

If something looks wrong and the provider cannot explain it, Medicare says to call 1-800-MEDICARE (1-800-633-4227) or report online through the HHS Office of Inspector General. The Inspector General’s fraud hotline is 1-800-HHS-TIPS (1-800-447-8477). Before calling, it helps to have the Medicare Number, the provider’s name, the date of service, the amount Medicare paid, the date on the notice and a sentence about why the charge looks wrong.

Medicare also says it will never call to sell anything, and that a Medicare card or Social Security number belongs only with a doctor or someone who should have it. The Justice Department’s account of the Thu sentence shows how far one doctor’s signature can reach.

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This article was produced with AI assistance and edited for accuracy against the sources linked above.